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Peninsula Regional Medical Center Quality Specialist - Ambulatory in Salisbury, Maryland

Job Summary:

Reports to the Ambulatory Quality Manager and works to provide patient-centered care delivery. Responsible for quality and value-based programs and initiatives. Responsible for development and direct oversight of assigned quality programs and quality metric compliance throughout the ambulatory network. Develops a variety of process improvement implementations while maintaining quality/safety/patient satisfaction metrics that are aligned with operational/program goals. Implements quality initiatives encouraging providers and staff to achieve a level of commitment and reliability that results in an interdisciplinary approach to quality-based care.

Works with and manages assigned quality programs in over 50 practices and over 250 providers across the ambulatory network, with responsibility for quality programs with the potential for greater than one million dollars in incentive reimbursements.

General Responsibilities

Manages assigned ambulatory quality programs:

Develops, implements, and tracks quality/safety/patient satisfaction metrics that are aligned with program and operational goals.

Collects, aggregates and analyzes performance improvement data and/or acts on opportunities for promotion of excellence throughout each practice.

Maintains up to date knowledge of quality measure specifications with regards to assigned value-based quality programs; updates Quality Team accordingly.

Provides guidance and support for data collection, analysis, and performance measurement to facilitate improved patient outcomes and organizational efficiencies.

Collaborates with quality team, ambulatory offices, and Administrative leadership to identify office-based improvement opportunities.

Manages assigned programs throughout the provider network. Has oversight and management responsibilities for specific quality programs with the potential for greater than one million dollars in incentive reimbursements.

Leverages principles of value-based programs to examine effects on costs of care, utilization, clinical quality metrics, and patient experience.

Reviews, tracks, and trends clinical performance metrics and escalates concerns as appropriate

Identifies coaching opportunities and provides information to improve areas including staff/providers and offices. Utilizes data gathered to design and implement workflow/process changes in conjunction with Quality and Operations Teams.

Designs communication plans to assure changes and updates related to process, workflow, or quality measure documentation needs are shared with all appropriate staff and providers.

Educates and provides reports and feedback for all providers on quality requirements.

Ensures program compliance with all applicable value-based contracts, regulations, and professional standards.

Works with Ambulatory Quality Manager or appropriate leadership to resolve any quality compliance concerns.

Ensures accurate and timely data while coordinating all entry within various payer portals is in accordance with established documentation standards

Gathers reports to identify gaps in care, recommends action and assists with gap closure as needed.

Completes rounding assignments throughout the network offices.

Actively participates in specific projects, process groups, and committees.

Prepares quality meeting materials and conducts training meetings as appropriate

work experience requirements

  • Working knowledge of clinical practice in office or hospital setting

  • Minimum 3 years prior related experience in a clinical setting required.

  • Strong computer skills and knowledge of PC applications, including EMR systems required

  • Proficient written and verbal communication skills, including the ability to present findings and implement effectively to a wide range of audiences and through a variety of settings.

  • Clinical information systems experience is strongly preferred

  • Project management experience recommended

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